Orofacial Myofunctional Evaluation And Treatment

What Are Orofacial Myofunctional Disorders (OMD)?

While all babies are born with a tongue thrust pattern and many suck their thumbs to calm themselves, most children outgrow these behaviors on their own. When a child does not outgrow these habits, however, speech, eating, and dental growth and development can be negatively affected. Examples of OMDs are a tongue thrust swallow, lisp, open-mouth resting posture, and thumb or finger sucking habit.

What Can Be Done To Help?

Many OMDs are best corrected through a team approach involving the child, family, dentist or orthodontist, and speech language pathologist (SLP). The speech language pathologist services at Johns Hopkins All Children's Hospital include an Orofacial Myofunctional Treatment Program. Our certified SLPs are specially trained in the evaluation and treatment of orofacial myofunctional issues.

At What Age Can My Child Begin?

A child with a thumb or finger sucking habit can be enrolled at five years of age. The best age to begin the tongue thrust correction program is eight years of age, with the majority of patients being 8-12 years old. Treatment may be recommended for younger children under certain circumstances.


The SLP will examine the child's oral structures, watch the child eat crackers and drink juice, observe the child's habitual resting posture, ask questions about feeding history, oral habits, and dental/orthodontic history, and assess the child's articulation (speech sound production). The appointment lasts about an hour.

Treatment May Be Recommended For A 4-7 Year Old Child If:

  1. No factors from the following list are identified, AND
  2. Dentist/orthodontist notes a developing malocclusion (overbite, overjet, open bite, etc.) AND
  3. Child demonstrates an open mouth resting posture but it appears the tongue will "fit" into the roof of the mouth, AND
  4. Parent agrees to follow through with daily home exercise program.

Treatment Is Not Recommended For A 4-7 Year Old Child If:

  1. A thumb or finger sucking habit is present. The habit must first be eliminated and re-evaluated in six months.
  2. Tonsils/adenoids appear enlarged OR allergies, sinus problems, or other airway interference is present. Must see pediatrician or ear, nose, and throat doctor first for medical management and re-evaluate in 3-6 months.
  3. Dentist/orthodontist plans to do rapid palatal expansion. Re-evaluate after RPE is complete. The child cannot do the required exercises with the palatal device in place.
  4. The child appears to have a tongue tie. Must be seen by an ear, nose, and throat doctor or oral surgeon to determine if he/she is a candidate for a lingual frenectomy. Re-evaluate six months after surgery.

Thumb Sucking Treatment Program

A positive behavioral approach is used to eliminate sucking habits. It generally takes six months to eliminate DAY and NIGHT sucking habits. The child will be seen for a 15-30 minute session once weekly for three weeks, for a six-week recheck, and a six-month recheck.

Schedule an Appointment

To schedule an appointment, physicians or patients may call the Patient Access Service Center at (727) 767-7272 or submit an online appointment request. We accept most traditional insurance, Medicare, Medicaid, and most managed care plans. A physician referral is required for this evaluation.